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Dexter Morgan is introduced as a police blood spatter analyst by day and serial killer by night. An unusual case begins with the finding of clean, chopped-up bodies with no blood. The murderer intrigues Dexter with the intricate methodology as well as a personal message.

The pilot begins with a narration by Dexter, who says that he is going to kill that night. Dexter kidnaps Mike Donovan, a child-killer, and explains that he has standards, and could never kill a child. Donovan is drugged and finds himself taped to a table, where Dexter collects some of his blood and kills him. Dexter narrates that he is not sure why he is a murderer, and talks about his adoptive parents, Harry and Doris Morgan, both of whom are dead. Harry lives on in the mind of Dexter like a shadow force that guides Dexter's thoughts. Dexter is both happy and haunted by Harry's guidance which is all too often in conflict with what he is working on. At his apartment, Dexter stores Donovan's blood in a case containing the blood of his other victims. Dexter explains that he kills according to a code taught to him by Harry, who, as a Miami police officer, instructed Dexter on how to avoid being caught, and to only kill those who deserve it.

Dexter stunned by the amazing work of the hooker killer.

Dexter receives a message from his vice squad officer adoptive sister Debra Morgan (Jennifer Carpenter), whom he believes is the only person to love him. Debra says that she is at a crime scene and wants him to be with her. Dexter arrives and Debra, undercover as a prostitute, informs him that another hooker has been killed, the third in five months. Debra, who wishes to work in the homicide department, believes that there is a serial killer behind the murders. Dexter inspects the victim and is shocked to learn that the chopped-up corpse has no blood whatsoever.

At the police station, Dexter discusses another murder case being handled by Sgt. James Doakes (Erik King), who deeply distrusts Dexter. Dexter suggests that it was a crime of passion, rather than the bad drug deal Doakes believes it to be. Dexter spies on Jamie Jerworski, a murderer who escaped justice, and breaks into his home to find proof of his crime. Once he confirms that Jerworski is guilty, Dexter meets with his girlfriend Rita Bennett (Julie Benz), a domestic violence victim. As a result of her violent past with her husband, Rita has no interest in sex, and Dexter secretly feels comfortable with the lack of intimacy. Rita also has two young children, with whom Dexter gets along well. While on a date with Rita, Dexter finds another crime scene in which the victim has been cut into pieces with no traces of blood; this time, however, the head is missing.

I'm watching you motherfucker!

Dexter contemplates that the killer murders his victims in extreme cold, explaining the absence of blood. Dexter further theorizes that a stolen refrigerated truck is being used for the murders. Dexter allows Debra to pitch the theory, but it is not well accepted by the other officers. In Lt. Maria LaGuerta's (Lauren Vélez) office, Doakes and Dexter continue to argue over Doakes' murder case.

Dexter captures Jerworski, who admits his guilt and explains that he has no remorse. After killing Jerworski, Dexter drives to see Rita, but is sidetracked when he sees a refrigerated truck. Dexter follows the truck, and the driver throws a severed head onto Dexter's car. When the police squad arrives, LaGuerta confirms that Doakes' case was indeed a crime of passion. Dexter arrives at Rita's apartment, where she expresses interest in taking their relationship to a more intimate level.

Dexter feels uncomfortable and is saved when Rita's son, Cody, begins vomiting. When Dexter arrives at his apartment, he finds a doll's head on his refrigerator's door. Inside the freezer, he finds the other parts of the doll, severed just like the bloodless bodies of the dead women. Dexter views the doll as an invitation to play, which he says he would like to do. Flashbacks throughout the episode show Dexter as a youth, when Harry discovers that Dexter has killed several dogs. Dexter explains that he has a desire to kill humans rather than just animals. Dexter is confused by his urges to kill, and Harry understands that while he cannot stop it, Dexter must use his urges for good.

The pilot premiered on October 1, 2006. It was watched by over one million viewers, giving Showtime its highest ratings in nearly two years. The edited version of the pilot episode that was broadcast on CBS on February 17, 2008, was watched by 8.1 million viewers, finishing third in its time-slot and giving CBS its best ratings in the 10 p.m. time-slot since December 2007. A little less than 300,000 viewers watched Dexter's premiere on FX in the United Kingdom, on July 10, 2007. On July 7, 2008 Dexter premiered in Australia on Network Ten, where it was watched by a little less than a million viewers, finishing highest in the 18-49, 16-39 and 25-54 demographics. Maganini won the 2007 Creative Arts Primetime Emmy Award for Outstanding Single Camera Picture Editing for a Drama Series.

Reviews of the pilot were generally positive. David Hinckley of the New York Daily News called it "bold, different and exciting, with a central character and performance that take your breath away." Hinckley praised Hall's dynamic Emmy-worthy performance, and the "indispensable and haunting" narration. Maureen Ryan of the Chicago Tribune claimed "to deny yourself the engrossing Dexter based on its subject matter would be to miss out on one of television's most fiendishly intelligent new dramas." Ryan enjoyed the series' black comedy aspects, which she thought were "infused with the most pitch-dark irony on television." Matthew Gilbert of The Boston Globe was impressed by Hall's grand performance, especially in his ability to made Dexter likable. Gilbert praised the set designers, comparing the crime scenes to a Vanity Fair photo spread. IGN declared the show as "Best New Psycho Drama of 2006." Critics reacted positively to the character of Dexter. Entertainment Weekly's Josh Wolk called him "the hippest-looking killer since American Psycho's Patrick Bateman." The San Francisco Chronicle's Tim Goodman described Dexter as "alluring, in a strange way," while Ryan found him to be "among the more compelling characters on the small screen." Gilbert described Dexter as a cross between Hannibal Lecter and Clarice Starling, calling him a vigilante obsessive murderer with a slippery personality, but "also a hero of sorts."

However, not all reviews were as positive. Robert Abele of LA Weekly thought the pilot was average, containing "fashionable gore, occasionally witty dialogue, serviceable suspense and boilerplate police-department politics." Abele felt that the series was a superhero tale, rather than the dark comedy, police thriller and brooding drama that it was promoted to be. Brian Lowry of Variety did not think that Dexter would impress critics, and noted, "antics of the deranged... aren't really all that pleasant to watch." Nancy DeWolf Smith of The Wall Street Journal felt that the "grotesqueries of Dexter are not something that can easily be dismissed with the old 'you don't have to watch' line. We don't have to watch. We do have to live among the viewers who will be desensitized, or aroused, by this show."

DEXTER is one of few television series that has a different name for the first episode than "Pilot," which is the commonplace in most shows. As an additional note, it's also one of the very few that names the Pilot after not only the main character but also the show itself. The episode however, isn't much the form of a pilot as everything of the production differs from the rest of the series (as all pilots suffer from a "different quality" than Episode 2 and on).

In the pilot, the Miami Metro Police Department is far different than the remainder of the series. The original set has some resemblance (specifically Homicide) but changes going into the second episode "Crocodile", where it stays the new set design afterwards.

None of the extra background detectives from the pilot carries on into the remainder of the series nor are any of the seasoned detectives such as Soderquist or Yale present during the Pilot.

The first kill room in the series is also used in Episode 810: Goodbye Miami, set up by Dexter to use on Oliver Saxon. Why Dexter chose to use this location is uncertain, it could be due to the remote location that he used to kill Mike Donovan 6 years prior. However, Dexter ultimately forgoes using this room due to constantly changing circumstances and apparently leaves this room intact after the finale as it's not seen again.

This is the only episode that does not contain either a recap or the opening title sequence, which are both understandable considering it was a Pilot pitched to showtime prior to having a title sequence (and its the first episode in the series, thus nothing to recap). In addition, the quality of filming in this episode compared to the remainder of the season is significantly lower budget at the time, as are most Pilots.

Angel Batista is shown wearing full dress pants, shirt and tie at his first crime scene (as well as the briefing) where normally he's seen wearing a more lax attire, usually an orange themed designer shirt and fedora. The normal outfit is later worn at the second crime scene in the episode and for the remainder of the series, only returning with suit attire after becoming Lieutenant of Homicide in Season Seven and on a few formal occasions.

James Doakes also wears a suit during the briefing, where in the remainder of the series he sticks to his usual attire.

The briefing room used in the pilot is never used again, as it's designed as a press room with a projector screen where various detectives and officers sit while the Lieutenant asks them of their progress. The briefing room used for the remainder of the series is located within the Homicide department, featuring various dry erase boards and is more compact than this spacious location.

This is the only episode where Dexter wears plastic wrap on his face when killing a victim. It's unknown why he does this, likely due to it being a more open location at the time of the Pilot but the idea was ditched going into the remainder of the series where often times he doesn't even wear the face mask to protect himself from the blood (though his methods of disposal become less bloody as the series goes on).

In the pilot, Dexter only has a Desk with his nameplate along with pictures of various crime scenes and so forth. This changes to an office moving forward in the series, with more privacy though at times he does work at a desk situated just outside of the office door.